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David E. Nelson, MD, MPH, Julie Bolen, PhD, Henry E. Wells, MS, Suzanne M. Smith, MD, MPH, MPA and Shayne Bland, MS

David E. Nelson is with the Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Ga. Julie Bolen and Suzanne M. Smith are with the Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention. Henry E. Wells is with the Research Triangle Institute, Atlanta, Ga. At the time of the study, Shayne Bland was with Children’s Hospital, Denver, Colo.

Correspondence: Correspondence should be sent to David E. Nelson, MD, MPH, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Mail Stop K-50, Atlanta, GA 30341 (e-mail: den2{at}cdc.gov).

Objectives. We analyzed state-specific uninsurance trends among US adults aged 18 to 64 years.

Methods. We used logistic regression models to examine Behavioral Risk Factor Surveillance System data for uninsurance from 1992 to 2001 in 47 states.

Results. Overall, uninsurance rates increased in 35 states and remained unchanged in 12 states. Increases were observed among people aged 30 to 49 years (in 34 states) and 50 to 64 years (in 24 states), and increases were also observed among individuals at middle and low income levels (in 39 states and 19 states, respectively), individuals employed for wages (in 33 states), and the self-employed (in 18 states).

Conclusions. Among adults aged 18–64, rates of uninsurance increased in most states from 1992 through 2001. Decreased availability of employer-sponsored health insurance, rising health care costs, and state fiscal crises are likely to worsen the growing uninsurance problem.

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